The Neurax Worm is a plague type that appeared in Mutation 3 or version 1.3 (August 30, 2012). Along with the two endings from the other plague types, the Neurax Worm has another ending which is triggered by evolving the Transcendence symptom. This causes the Neurax Worm to enslave humanity and force them to worship it.

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The Neurax Worm is a special disease type which has been awakened from its millennia-long slumber by human activity. Its defining trait is the ability to burrow into the host's brain and exercise inner mind control. You can unlock it by purchasing it for $2.99 USD or by beating all disease types on brutal (mobile) or beating the Fungus disease on Normal or higher (PC).

The Interface of the Neurax Worm shows a small worm with the head of what somewhat resembles a snake. As the severity of the disease increases, the neural branches will spread from the worm's mouth across the brain, until it has entirely encompassed the brain (to represent the worm gaining complete control of its host).

There is also a special scenario called Santa's Little Helper, where the world has turned dark and gloomy. Land borders, airports and seaports have been shut down to reduce people's happiness. People are forced to wear grey clothing, and holidays and laughter have been made illegal. The player must play as the Neurax Worm and make everyone happy again.

The Neurax Worm begins with three unique transmission options: Concertina Locomotion, Eggs, and Genetic Swap. Concertina Locomotion and then Undulatory Locomotion must be taken before Air and Water transmission are unlocked; Eggs must be taken to give the player access to Birds, Insects, and Rodents; while Genetic Swap branches into an entirely unique set of transmissions. The Genetic Swap transmission allows the player to then choose from Mutative Regeneration (increasing chances of mutation) or Corpse Feeder (increasing infectivity where corpses are present). Both have two stages.

The Neurax Worm gives the player two options to complete the game: the first, as usual, is to simply wipe out humanity. The second option is to enslave mankind. This plague is unique in that not all of its symptoms kill people directly but instead change the mental state of the host to one of aggression (murdering others) or depression (suicide).

The Neurax Worm makes use of the unique ability 'Trojan Planes'. These planes will randomly generate as bubbles throughout gameplay in infected countries - appearing in the same fashion as DNA, Infection, and Cure bubbles. The player can purchase three stages of Trojan Planes in the Abilities section with DNA points, each additional tier adding to the likelihood that a Trojan Plane bubble will appear. The bubble can then be dragged over the designated target country, resulting in the start of infections in said area. This ability is very useful for infecting hard to reach countries such as Greenland and Morocco. This ability still can be used even when the government closed down the airport or there is no airport present in the country, making it a popular choice for players.

After the Trojan Plane ability has been taken, the player will then be able to purchase the abilities 'Trojan Roamers' and 'Trojan Destroyers', each having two stages with increasing severity. Trojan Roamers increase infectivity rates in the country they land in, while Trojan Destroyers aid lethality by causing aggressive and destructive behavior in the host arriving in the targeted area.

This plague type is relatively easy to master, and with the right strategy, it is the go-to plague type for most scenarios where the plague type is not locked.

DNA points pile up quickly with this disease type, and visibility is not an issue. Once the Trojan plane ability has been evolved, countries closing their borders, ports, and airports becomes a non-issue. Even the infamous Greenland can be breached by a Trojan Plane.

This plague type also has the symptom Transcendence, which has a cure effort-crippling effect plus the ability to bring about an early, successful end to a game, by enslaving humankind. Other symptoms, such as Suicide and Coma, can cripple cure effort and kill large amounts of people in short amounts of time, unlocking the achievement Worm Food. There is an entire symptom tree dedicated to slowing the cure.

For this plague type, Transmission and Ability traits both increase severity, and thus the likelihood of the disease being noticed and cure research beginning, even before actual symptoms are present. However, several Symptoms can be purchased to counter this that decrease severity and the chances of a host noticing the worm.

This plague type requires quite a few DNA points to be spent in Symptoms before it can either kill or control the human population, so be sure to stock up once infection rates are steady.